RTÉ’s Health Correspondent Fergal Bowers @FergalBowers takes a look at some of the issues on the agenda at the IMO's annual conference

Doctors gather in Killarney this week for the three day annual conference of the Irish Medical Organisation, which starts on Thursday.

The beautiful setting of the lakes of Killarney and the plush Hotel Europe is in stark contrast to the controversy the organisation has been facing over the retirement package for its former chief executive and its staunch opposition to the Croke Park II agreement.

The IMO is the biggest doctors' union, with over 5,000 members across all medical areas - consultants, GPs, non-consultant hospital doctors and public health doctors.

The AGM is a major event and one I have covered every year since 1988.

It's as much a business meeting as an opportunity for doctors and their partners (and some children) to enjoy a good social gathering.

Killarney usually delivers as a picture postcard venue and the television interviews and ”lives” by the lake show off the true beauty of The Kingdom.

And the RTÉ camerman who makes it all look so well is usually my colleague Neilus Dennehy along with the various hard-working Satellite Mobile Unit operators and crew back at base in Dublin.

Over the three days, there will be hundreds of motions debated, including one calling for legislation for termination of pregnancy where a woman becomes pregnant due to a criminal act and in the case of non-viable fetal abnormalities.

Another motion calls for support for regulation for abortion services where there is a real and substantive risk to the life of the mother, which will be debated in the aftermath of the report into the death of Savita Halappanavar.

There was a time when the very mention of the abortion issue at an IMO conference resulted in very heated exchanges between doctors.

Doctors are also calling for on-the-spot fines for anti-social behaviour, of which hopefully there will be none at this agm which is likely to be a very tense affair.

Non-consultant hospital doctors have also been complaining about dangerously long hours they still have to work, despite the legislation on a 48 hour week.

This is also the last year for some time that the annual conference will be in Killarney, its home for many years past.

The organisation had wanted to move this year's venue in the wake of the controversy over the payout to its CEO but there would probably have been a financial penalty if it withdrew at such short notice.

In 2013, this wonderful venue may not be sending out the right message for a union in difficulty and during a time when the country's finances have undergone radical surgery.

So this agm is likely to be somewhat scaled down to give a sense of austerity among the medical profession, which has been hit by pay cuts and some fall in income as private patients in financial hardship think twice about going to the doctor due to the cost.

Suggestions that the IMO is in financial trouble have been dismissed by the union, which points to the € 3.2 million in reserves plus property it has after the settlement with its former CEO.

Following a recent extraordinary general meeting, IMO members agreed to commission an outside review of financial issues, including the circumstances of the former CEO's contract.

The advertisement for that review will be published just before the conference begins.

An oversight committee is also being set up to review corporate governance and an executive committee is acting in the place of the former CEO on an interim basis, until a new boss is found.

Health Minister James Reilly is a former president of the IMO but he cannot make the AGM this year.

He is facing heavy criticism from GPs who have warned him against imposing any more cuts in the payments they receive for caring for people with medical cards.

The minister has to make a decision soon on how much he intends to cut GPs' fees by under the Financial Emergency Measures in the Public Interest legislation.

The minister will also miss some of the social programme at the conference, including golf at the nearby Kileen golf Club, a session on how to create simple and sophisticated desserts and a make-up tutorial on how to “achieve a natural day look and a glamorous evening look”.

I recall one IMO agm many years ago when packets of a well-known brand of headache tablet were left on hotel room pillows for all delegates, as a free sleep well gift.

These days, it's most likely to be a generic equivalent.

The theme for this agm is 'Renewal, Action and Leadership' and the IMO's president, Dr Paul McKeown says this is a time of unprecedented attack on the health service as well as the IMO itself going through a period of great controversy and frustration.

There will be big debates on how medicine can be bad for doctors' health, coping with stress and burnout and ethical issues from beginning to the end of life.

Back in the late 1980s and early 90s, this doctors' union went through a very difficult time and saw threats of legal action at annual conferences and huge internal turmoil.

Doctors will be conscious of the need to turn their attention back to the issues facing patients and the provision of a health service during a time of great austerity.

There is a danger, depending on how this conference goes, that this proud organisation could get bogged down in internal battles and legal issues for some time.

The IMO, along with the Irish Nurses and Midwives Organisation and some other unions, is opposed to the pay cuts in Croke Park II.

The IMO walked out of talks just hours before a deal was done at the Labour Relations Commission recently.

There is the real possibility that the Government might legislate to impose pay cuts on doctors and that could spark major industrial relations unrest.

So this is a testing time for the Irish Medical Organisation and its new president, Dr Matt Sadlier, who will take over the gold chain of office on Saturday evening, before the traditional Black Tie banquet.

As well as being a respected psychiatrist, Dr Sadlier is also is a very talented comedian - no joke.

He will need both skills to manoeuvre doctors through the difficult times ahead.

I will be covering the agm on RTÉ News Thursday to Saturday and updating developments on Twitter @FergalBowers